Who Really Understands ObamaCare? – Kaiser Health News

Commentary by John C Goodman

January 21, 2010

Source: Kaiser Health News

From the very moment public opinion started going south on the president's health plan, the White House and Democrat leaders in Congress began sounding a familiar refrain: The public does not understand the bill; they've been lied to, deceived and misled by the opponents; and once they learn how it really works, familiarity will breed...well, something other than contempt.

I have four problems with this point of view:

1. If it is sincere, you would think the Obama Administration would have made a major effort to educate the public about how the bill really works; in fact, they have made no effort whatsoever.

2. Since ObamaCare is modeled after the Massachusetts health plan, voters in that state should be better informed than even Obama himself about how it "really works"; yet Massachusetts voters resoundingly rejected the president's plan in Tuesday's U.S. Senate election.

3. There was a lot of misleading information flying in all directions at last summer's town hall meetings; but on balance, the average protestor appeared to be better informed than the average member of Congress.

4. Among the chattering class - who are paid to express informed opinion - the proponents of ObamaCare are far less knowledgeable than the opponents.

Cognoscenti are in the Dark. Let's take the last point first. How many editorials have you seen where the writer rattles off a laundry list of health care problems and then concludes with "that's why we need health reform"? Each of these editorials makes the same two mistakes: (1) They assume that ObamaCare will solve the problems they are writing about and (2) they assume it's either ObamaCare or nothing. This second mistake is called the fallacy of the excluded middle.

As we have pointed out many times, ObamaCare is not going to solve our most serious problems. It will make costs higher, not lower. It will lower, rather than raise, the quality of care. It will "solve" the problems of pre-existing conditions by substituting problems that are even worse. And it may not even increase access to care.

Then there are the writers who bypass the details altogether and jump straight to wild claims. Here are two:

["ObamaCare] will give Americans what citizens in every other advanced nation already have - guaranteed access to essential care. " (Paul Krugman in The New York Times)

For the first time, we will enshrine the principle that all Americans deserve access to medical care, regardless of their ability to pay." (Eugene Robinson in The Washington Post)

Now you would think that anyone who hasn't been living in a cave in some remote spot would know that access to the care they need is exactly what many Canadians and Britains do not have. And if they do not have the money to buy that care in the private sector or in another country, they are forced to go without because of lack of "ability to pay."

Bay State Folks Know What's Happening in Their State. We don't have to go all the way to Britain or Canada to see where Krugman, Robinson and others have missed the boat, however. Massachusetts will do just fine. Bay Staters are not clamoring to repeal what they have. But they are acutely aware of the problems that haven't been solved. And one of them is lack of access to care for people who lack the ability to pay market prices. As previously noted, the wait to see a new doctor in Boston is more than twice as long as in any other U.S. city. Further, the number of people going to emergency rooms for nonemergency care in Massachusetts is as great today as it was before health reform was enacted.

The White House is Doing Nothing to Educate the Public. It's not just the general public that is being kept in the dark. Obama is the same way with his base. Since June, the president has been sending a weekly e-mail to an estimated 19 million faithful about health care. Strangely, these letters are never truly educational. Instead they are cheerleading messages - the sort of thing you would expect at a pep rally. (By contrast, the NCPA's weekly messages to 1.3 million petition signers tend to be very informative.)

Voters on the Whole are Very Informed. There has probably never been a major piece of legislation before Congress about which voters were better informed. I continue to believe that the average "activist" who opposes the bill knows more about it than his/her congressional representative. Rasmussen found that after an initial poll question, people were just as negative - if not more so - when pollsters described ObamaCare in some detail.

As Lanny Davis said the other day, "It's the substance, stupid."

John Goodman is the President and CEO of the National Center for Policy Analysis